Holistic health is like cooking, not baking
On adopting a systems theory of the body in addition to a mechanistic one
Right now I am learning to cook new meals based on principles from Sowa Rigpa (traditional Tibetan medicine1). Finding a more healthy way to eat has been a lifelong struggle for me that I have only begun to tackle in the last year. Throughout most of my life, I thought eating healthy was nothing more than avoiding cravings for things that were “bad” and trying to force myself to eat things that were “good.” I was also a vegan for six years, and during that time it was really important for me to get enough protein and certain vitamins that vegans can be prone to being deficient in such as Vitamin B-12. However, being very focused on getting specific nutrients that I was missing made eating feel very utilitarian for me, as my love of food became replaced with trying to make certain nutrient quotas. Now I am finding joy in eating and cooking food again, and it’s thanks in part to adopting a new mindset about eating that I’m learning from studying Sowa Rigpa.
On Traditional Eastern versus Western Nutrition
While many people equate eastern traditional medicines with acupuncture or herbal medicine, in most of the traditions I’ve studied so far, nutrition is considered to be the most fundamental thing you can do for your health. If you’re eating in a way that is throwing your body off balance, there is really very little that acupuncture treatments, as helpful as they may feel in the short-term, can do fo your long-term health. In fact, acupuncture is considered a more serious intervention (in Sowa Rigpa for example it is classified as a “minor surgery”) and some eastern medicine traditions won’t recommend it until after you have tried making alterations in your diet, lifestyle (this includes fixing sleeping patterns, finding appropriate amount of exercise, reducing stressful situations, and working on reducing addictive habits), and herbal medicine first.
Western biomedical advice also acknowledges the importance of nutrition too; we all know that certain foods are known to elevate the risk of many of the major chronic diseases westerners suffer from such as heart disease, cancer, and type II diabetes. While some links are well-established between nutrition and disease (for example we know that folic acid is important for pregnant women to take for fetal development) there is still a lot of unknowns and unproven theories. Nutritional epidemiology is a field that is still evolving and this along with journalists who misrepresent the smaller claims of nutritional science for more sensational headlines, and political actors (NGOs and industry lobbyists) desiring to influence what we consider to be healthy, leaves many people feeling very confused about what is best to eat.
When you go to your medical doctor with a concern that there may be something going on between your diet and your health, you will most likely asses you for specific macronutrient (protein, fat, carbohydrate) and micronutrient (vitamins, minerals) deficiencies, and will also recommend you reduce or increase certain foods that are known risk or protective factors for whatever specific health conditions you may have (or be at higher risk for). You can also get tested by an allergist, and if you need help designing meal plan based on your health condition, you may be referred to a registered dietician. Discussing your nutrition with your general practitioner is well worth it, and in my humble experience as a patient with a health condition affected by diet, rarely at odds with following advice from traditional eastern medicine. For example, last year when I first told my doctor that I believed my hypoglycemic symptoms were getting worse, she did a blood panel on me, and it was discovered I had a Vitamin D deficiency. While that might not have been the primary cause of my hypoglycemia, tackling that issue before I dove into changing other aspects of my diet was very helpful, and I’m glad I started with it.
But what happens when you have no known nutritional deficiencies, no lab abnormalities, and are not consuming foods you are allergic to, and you still feel something is still not being addressed regarding your diet and your health? This is where nutritional wisdom from eastern traditional medicines has been helpful for me. Sowa Rigpa has guided me toward certain types of foods and away from others that seem to affect my well being on a more subtle (sub-clinical) level. Modern biomedical research is very good at breaking things down into parts: identifying specific variables that can be altered to affect specific health outcomes (for example a Vitamin D deficiency can reduce one’s ability to absorb calcium and phosphorous). Eastern traditional medicines can sometimes be better equipped to explain the behavior of the body as a whole system and clarify why certain holistic patterns may be occuring. For example, western biomedicine might ask “what foods should I eat or avoid to reduce my risk of heart disease?” while eastern medicine might ask “what foods can I eat at what times that will make me feel less sluggish and more energized?” Nutritional guidance from eastern traditional medicines has complemented the nutritional testing I got from my medical doctor by teaching me pattern thinking and decision-making.
On multi-level causation
What is “pattern thinking?” It is a way of understanding phenomena at a different level of causation than we do mechanistically, by paying attention to patterns and bigger level trends in an ecosystem (in this case the body) in order to predict things. It’s how indigenous people were able to survive in their local environments — seeing patterns in different ecological phenomena, and being able to predict for example, where to find food without needing modern technology to do so. And it’s largely how eastern traditional medicines were able to recognize interconnected patterns between health phenomena before the advent of modern science.
Information derived from pattern thinking doesn’t have to be in competition with health knowledge revealed by evidence-based medicine. Evidence-based medicine usually reveals a quantitative relationship between a pharmaceutical or other health intervention and signs or symptoms of specifically defined disease. However, holistic wellbeing usually involves many health phenomena, some of which occur at a different level of causality beyond the biochemical or biomechanical ones. What do I mean by levels of causality? Aristotle actually had a concise way of explaining multi-level causation using an example of a statue that I will summarize here. One way to explain the existence of it’s statue is to explain it’s “material cause”: a bronze statue exists because of the bronze that constitutes it. But the existence of a bronze statue can also be explained by something he called the '“efficient cause” which is the source of change. In this scenario, the source of change is the artist who carves the bronze into a statue. He also goes on to describe two other levels of causation — form (the shape that the bronze is carved into means it is a statue, and not a cup for example), and reason (why did someone hire an artist to turn the bronze into a statue in the first place?)
Eastern traditional medicines operate at the “efficient cause” level — the dynamic forces which shape our health. This is a departure from a lot of western biomedicine which focuses on the material mechanisms of disease. Many traditional medicines classify these dynamic forces into elemental archetypes (like wind, earth, water, and fire) to describe how certain dynamics that play out within the body fit into semi-predictable patterns. For example, I live with what western biomedicine calls autonomic neuropathy (my autonomic nerves are damaged and oftentimes my body sends inappropriate signals to other parts of my body when trying to regulate itself) but according to Sowa Ripga I have a “wind” pattern. Wind is prone to fast changes, and is subtle (more difficult to detect), and has a number of other attributes that make it a fitting archetype to describe the way the disease plays out in my body. My disease causes hard-to-pin down, migratory pain and other symptoms, that can often change rapidly and are very reactive to environmental stimuli, so wind is actually a very fitting archetype. For wind-type patterns, foods with certain qualities are recommended: I need more oily and fat-rich foods; warm, not cold foods; and need to be more careful of things that may dry me out and make me more jittery like coffee.
Nutritional decision-making from an eastern traditional medical perspective is more involved than just knowing your type and following the guidelines for your type. Although the primary disease I suffer from is a wind in nature and my constitutional archetype is also wind according to Sowa Rigpa, it does not mean that that eating foods that are suited for wind patterns is always the best advice for me. I may, for example, be suffering from a health pattern on a particular day that is more fire-like in nature, or perhaps maybe it is very hot outside, or perhaps it is a time of day when all of us are prone to having higher body temperatures. In those instances I have to take into account the temporary or environmental conditions that might cause me to want to “balance” other elemental dynamic forces like fire, earth, or water. Eating like this requires paying attention to my environment, my circumstances, and myself. Traditional eastern nutritional guidance does not need to deny that there are biochemical reasons for why certain foods make me feel a certain way, it just focuses on interventions at the pattern-level, not the nutrient level. And in my experience so far, it has been working!
On complexity, emergent phenomena, and predictability
Some health phenomena, like psychological ones, cannot be functionally reduced to a few specific variables (“separating the signal from the noise”), instead, some are emergent properties of a complex system. To explain what complex systems and emergent phenomena are, I will invoke one of the greatest cultural artifacts from the 1990s — Dr. Ian Malcolm from the Jurassic Park movie and novel.
In case you haven’t watched the move over twenty times like I have, I will offer a synopsis: a hubristic billionaire decides to clone dinosaurs using dinosaur DNA that was discovered preserved since prehistoric times in amber. The reason for resurrecting these once extinct, magnificent species, which in includes nine-ton T-rex, is to generate revenue for an overpriced theme park, because of course it would be. In an attempt to control the dinosaurs behaviorally (so that they cannot breed with one another for example), certain genetic modifications at the DNA-level are made while cloning them. Before the park is set to open, the famous theoretical mathematician Dr. Ian Malcolm is recruited by the billionaire alongside a team of other well-regarded scientists to lend his brand more credibility give advice about risk management, which turns into words of caution that are completely ignored. As a theoretical mathematician, his words of caution come from his views of phenomenology based on his field of study, which is how chaos in complex systems operate. Complex systems are systems with many interconnected, non-linearly related variables interact with one another, like the weather, and in which emergent phenomena occur, like hurricanes, that are more than just a sum of all their small parts. He explains that although the scientists may have believed they’ve figured out way to tame the dinosaurs by making small tweaks in their DNA, that they will still undoubtedly be ignoring hidden relationships between unconsidered variables and the behavior of the system as whole, and the whole thing will most likely go in a direction they weren’t predicting.
“Living systems are never in equilibrium. They are inherently unstable. They may seem stable, but they’re not. Everything is moving and changing. In a sense, everything is on the edge of collapse.” - from Jurassic Park the novel, by Michael Crichton (who was both an MD and a mystic!)
Turns out he was right. The dinosaurs escape and start eating everyone, and the only way that the scientists who survive the event do so is by combining all of their specific, technical knowledge (including input from botany, paleontology, and computer informations systems) and integrating it with intuitive flexible decision-making and compassion— just like your medical doctor and your traditional medicine practitioner actually makes decisions about your health unless they are a robot.
I don’t think the central message of Jurassic Park is that things are so complex that they can and never should be studied scientifically, it is to remind us that living systems cannot be completely controlled by tweaking their parts, and that when we do dissect things into parts, we have to put those parts back into context with the larger system and not ignore other important faculties of our mind like intuition and pattern thinking. This does not mean, however, that certain questions should never be asked on the small-parts level. Where I think this relates to nutrition and other dimensions of health, is that are there are some health phenomena such as “having good energy” that may be emergent, versus others that may be more specific like “I want to control my blood glucose levels.” There isn’t really one food or one health practice we can point to that will be a silver bullet for supporting “feeling our best” through our food, but we can aim toward it through adopting a pattern of eating and lifestyle behavior that is.
Why advice from traditional medicines is more like cooking than baking
Because eastern traditional medicines address health issues at the pattern-level, the interventions are more adaptive than static, and intention-based rather than rigidly prescriptive, they are more akin to cooking a meal than measuring out all the ingredients precisely and leaving it in the oven for a designated time period without tasting anything and making adjustments. To approach nutrition this way, one needs to be aware of how their body is feeling, and adapt their “recipe” to what’s going on. This includes making changes based on the season, time of day, and place you’re living in. This is not as simple as taking a vitamin twice a day and putting your health issue at the back of your mind, it requires being actively engaged with what is happening with you and outside of you. The beautiful thing about this approach is that in order to do this, you have to be in relationship with yourself and your environment, and I have found that this approach makes life feel more connected and meaningful. I have stopped making decisions based on what foods are “bad” or “good” and instead ask myself “what will nourish me right now?”
The downside to approaching health and wellness in this manner is that it is time-intensive and difficult to study scientifically using our gold standard of evidence in biomedicine: the randomized clinical trial (RCT). RCTs seek to quantify how specific medical interventions affect specific health outcomes, holding all other variables constant. The evidence that they generate is useful and important, but they cannot provide the answer to every question. For emergent phenomena in preventative health, they may be unhelpful by themselves for a number of reasons — holistic eating is a complex intervention (there is not one specific food you are changing but many in combination), and it is adaptive, and asks the patient to make changes based on how they feel not just on what the practitioner or health professional proscribes.
Just like a physicist can study light as if it were a discrete particle and also study it as if it were a wave, we can study the human body through both a mechanistic and a complex systems lens. Different lenses generate different insights, and my belief is that there is a way of integrating them. As a person who has struggled with chronic health problems for almost the entirety of my life, combining evidence-based medicine, along with ancient wisdom about health patterns, alongside knowing myself and being in relationship to my environment, are the only way I’ve found to effectively manage it. And even then, there are some things I simply cannot change and must just accept. We can not control and predict everything and there is beauty in accepting that too.
Most of the advice I’ve been following has come from The Tibetan Book of Health by Dr. Nida Chenagtsang published by Sky Press.